People with Darier’s disease can go into depression

People with Darier’s disease can go into depression

It is a rare disorder, inherited in an autosomal dominant pattern

New Delhi, 04 December 2017: Recently, a case of Darier’s disease was reported from a city in North India. So far, about 15 cases have occurred in India, with this being the first in Uttar Pradesh. The disease is so rare that it affects only one out of one lakh people. Although the disease does not kill, it can be potentially debilitating for the person in question and put them on lifelong precautionary treatment.

Darier disease is a skin condition characterized by wart-like blemishes on the body. The blemishes are usually yellowish in color, hard to the touch, mildly greasy, and can emit a strong odor. The most common sites for blemishes are the scalp, forehead, upper arms, chest, back, knees, elbows, and behind the ear. The mucous membranes can also be affected, with blemishes on the roof of the mouth (palate), tongue, inside of the cheek, gums, and throat.

Speaking about this, Padma Shri Awardee Dr K K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement, said, "The wart-like blemishes in this disease usually appear in late childhood to early adulthood. Without precautionary measures, it can become more severe over time with the affected people experiencing flare-ups alternating with periods when they have fewer blemishes. The appearance of the blemishes is influenced by environmental factors such as heat and humidity; UV light; minor injury or friction; and ingestion of certain medications. At times, people with Darier disease may have neurological disorders; and issues with learning and behavior as well. This condition is inherited in an autosomal dominant pattern, which means one copy of the altered gene in each cell is sufficient to cause the disorder.”

Itching is very common in those with this condition.  The affected skin may smell unpleasant, particularly in moist areas. This is probably caused by increased numbers of ordinary skin bacteria growing in the affected skin.

Adding further, Dr Aggarwal, said, “The diagnosis of Darier’s disease can often be made on the appearance of the rash and the fact that it runs in families.  To confirm it, a small sample of skin (a biopsy) can be removed under a local anesthetic and examined under the microscope in the laboratory. Genetic testing to identify a mutation in the ATP2A2 gene can be used to confirm the diagnosis as well.”

Some precautions to be taken for those with this disease include the following.

• Avoid stress, excessive humidity, heat and tight clothes and use moisturizers, sun block and wear the right type of clothes which absorb sweat and keep the body cool.
• For localized lesions, dermabrasion can be done. Topical retinoids are also prescribed and are beneficial.
• If the patient has secondary bacterial infection, then antibiotics are prescribed. Antiviral medications are prescribed if the patient has herpes simplex.
• For severe symptoms, oral retinoids  can be prescribed, but these medications have serious side effects and need to be used with caution. Topical or oral antibiotics can be prescribed during flare ups.
• Using sunscreen and taking vitamin C tablets helps in preventing flare ups in some patients.

Patients should also maintain good hygiene to prevent flare ups. 

Even those with HIV/AIDS have the right to good health

Even those with HIV/AIDS have the right to good health

More efforts are needed to combat this disease entirely by 2030

New Delhi, 01 December 2017: By the end of last year, there were 2.1 million people living with HIV, with new infections falling to 80,000 in 2016 from 150,000 in 2005. Of these, 9,100 infected were children under age 15 years. Although there has been a registered 20% annual decline in new infections over the past few years, more efforts are required to completely combat the disease by the year 2030. There is a need to create awareness about the fact that everyone with AIDS must be accorded treatment at the right time to help them achieve good health.

This year, the theme for World AIDS Day is “Right to Health”. The WHO will highlight the need for all 36.7 million people living with the condition, to reach the goal of universal health coverage by 2030.HIV is a condition which targets the immune system and weakens people’s defence systems against infections and some types of cancer. The virus destroys and impairs the function of immune cells, thus gradually making infected individuals become immunodeficient.

Speaking about this, Padma Shri Awardee Dr K K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement, said, "HIV/AIDS continues to affect the Indian population despite various mass awareness campaigns, availability of various state-of-the-art medical interventions, and evolving technology. A large part of this is also due to the social stigma that our society has associated with the disease. This is also one reason why people avoid routine checkups. There is an urgent need to educate the masses about the various disease prevention measures along with the fact that people with HIV can live a normal life. The government and various healthcare associations must also ensure the availability of condoms in smaller cities and towns where the disease is more rampant.”

HIV and AIDS are different terms. HIV or Human immunodeficiency virus attacks and destroys white blood cells or T Lymphocytes in the immune system making the body prone to all types of diseases. AIDS, on the other hand, is a condition, which develops in the advanced stages of HIV infection due to a weak immune system.

Adding further, Dr Aggarwal, said, “HIV can spread from an infected woman to her child during pregnancy and childbirth. It can also be passed from a mother to her child through breastfeeding.All pregnant mothers should get HIV test done.Antiretroviral therapy (ART) should be started at the earliest to prevent HIV transmission to sexual or drug using partner/s or from the mother to the infant during pregnancy or breastfeeding.”

Here are some other facts about the disease.

• ABC for safe sex: Abstain, Be faithful to your partner and if you cannot, use Condoms.
• Drinking alcohol or taking drugs interferes with judgment. Even those who understand the risks of AIDS and the importance of safer sex may become careless after drinking or using drugs.
• People with STIs should seek prompt treatment and avoid sexual intercourse or practice safe sex.
• Used infected razor blades, knives or tools that cut or pierce the skin also carry some risk of spreading HIV.
• HIV-positive people may remain asymptomatic but can still pass on the virus to others.

More awareness needed on Scrub Typhus in India

More awareness needed on Scrub Typhus in India • Disease causes symptoms similar to chikungunya • Timely treatment can prevent death New Delhi, 15 September 2017: A bacterial infection taking a toll on many, scrub typhus causes symptoms that are akin to chikungunya. In 2016, of the 150 tested for the infection, 33 were positive. There are 35% to 40% chances of fatality if the disease is left untreated. As per the IMA, there is a need for greater awareness on scrub typhus among physicians working at the primary and secondary care levels as well as for better availability of diagnostics in the healthcare system. Scrub typhus spreads when chiggers – mites found in forests and, more recently, in urban shrubs – bite the person and inject the bacteria called Orientia (earlier called Rickettsia) tsutsugamushi into the blood. Speaking about this, Padma Shri Awardee Dr K K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement, said, "Scrub typhus may begin insidiously with headache, anorexia, and malaise, or start abruptly with chills and fever. As the illness evolves, most patients develop high fever, worsening of headache severity and myalgias. A characteristic eschar, an ulcerated area with a black necrotic center, may often develop at the site of the bite and is diagnostic. Approximately one-half of all patients develop a characteristically nonpruritic, macular or maculopapular rash, which typically begins on the abdomen and spreads to the extremities. The face is also often involved. Patients treated with appropriate antibiotics typically become afebrile within 48 hours of starting treatment. This response to treatment is useful diagnostically; failure of defervescence within 48 hours is often considered evidence that scrub typhus is not present.” The disease has an incubation period of 6 to 21 days, and lasts for 2 to 3 weeks. Patients with a mild infection may recover without any other symptoms. The differential diagnosis of scrub typhus includes malaria, dengue, leptospirosis, Chikungunya and other rickettsial infections. Adding further, Dr Aggarwal, said, “Several studies have demonstrated that chemoprophylaxis with a long-acting tetracycline is highly effective when used by nonimmune individuals living or working in areas in which scrub typhus is endemic. The use of insect repellants and miticides are highly effective when applied to both clothing and skin. Permethrin and benzyl benzoate are also useful agents when applied to clothing and bedding.” The following tips can help to prevent scrub typhus. • Avoid travelling to places where mites are known to be present in large numbers. • Wear protective clothing when travelling to an endemic area. Long sleeved clothes can prove helpful. • Apply mite repellents to exposed skin. • Those with risk factors and who work in an endemic area can be given once weekly dose of doxycycline.

HSV-1 increasingly becoming a cause for genital herpes

HSV-1 increasingly becoming a cause for genital herpes The disease is incurable but can be managed by practicing safe sex and with medications New Delhi, 24 August 2017: As per recent statistics, about two-thirds of the world's population under 50 has the highly infectious herpes virus. More than 3.7 billion people under the age of 50 suffer from the herpes simplex virus type 1 (HSV-1), which they usually contract in childhood. As per the IMA, this virus causes cold sores around the mouth. HSV-1 is increasingly becoming a cause of genital infection too, mainly in rich countries. A genital herpes outbreak or episode can occur when the HSV-1 or HSV-2 virus is reactivated from its dormant stage. This is an incurable disease, and once contracted, a person may experience outbreaks throughout their lifetime. The first outbreak of herpes is often the longest. Speaking about this, Padma Shri Awardee Dr K K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement, said, “Genital herpes is a sexually transmitted disease (STD) which causes herpetic sores. These are painful blisters (fluid-filled bumps) that can break open and ooze fluid. These viruses get into the body through the mucous membranes which are thin layers of tissue lining the openings of the body. These are found in a person’s nose, mouth, and genitals. Once inside the body, these viruses incorporate themselves into your cells. As viruses multiply or adapt to environments very easily, treating viral infections becomes difficult. It is important to inform the doctor if you have genital herpes during pregnancy. This will enable them in taking precautions to prevent the virus from being transmitted to the baby during delivery.” Some general symptoms in both men and women include blisters on the mouth, lips, and elsewhere; itching or tingling in the infected area; ulcer and oozing in the blisters; crust over the sores; swelling in the lymph glands; and headaches, body aches, and fever. Adding further, Dr Aggarwal, said, “It is important to practice safe sex and use condoms during intercourse to prevent genital herpes and other STDs from spreading. Although there is no cure for this condition, medication can help in managing it. The disease tends to stay dormant within the body until something triggers an outbreak such as stress, illness, or tiredness. Discussing it with the doctor can help in arriving at a correct treatment plan.” Here are some tips to prevent genital herpes. Use a condom every time you have sex. A latex condom can give protection from the herpes virus if it covers the infected area. Enquire about your partner’s sexual history A person with many partners is more likely to be infected with the virus. Indulge in safe sex Don't have sex with a partner who has sores on his or her genitals. Get your partner tested If you think your partner is at high risk for genital herpes, you may consider asking him or her to be tested. In that case, you should be tested, too.

Patients with family history of high cholesterol should be screened early

Patients with family history of high cholesterol should be screened early New Delhi, 27thMarch 2017: A person is said to be suffering from pre-mature heart disease when he is diagnosedwith the condition before the age of 55 years in men 65 years in women. The prevalence of dyslipidemia in these patients is usually found to be as high as in the range of 75-85%, said Padma Shri Awardee Dr KK Aggarwal, National President, Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA. Dyslipidemia is high levels of cholesterol and/or triglycerides in the blood. About 54% of all patients with premature heart disease and 70% of those with a lipid abnormality have a familial disorder. Hence, it is recommended that the first-degree relatives of patients who have had a heart attack, especially if premature, should be screened for lipid abnormalities. First-degree relatives of a person include brothers, sisters, father, mother or children; second-degree relatives are aunts, uncles, grandparents, grandchildren, nieces, or nephews and third-degree relatives refer to first cousins, or siblings of grandparents. “Screening should begin with a routine lipid profile and if the results of this are normal, then further testing should be done for lipoprotein (a) and apolipoproteins B and A-I. About 25% patients with premature heart disease and a normal standard lipid profile may have abnormal Lp(a) or apo B profile. High apo B levels and reduced apo A-I levels are associated with increased risk of heart disease. Similarly, a high Lp(a) level increases the risk of developing heart disease”, added Dr KK Aggarwal. Familial hypercholesterolemia (FH) is a genetic disorder, which runs in families and is characterized by high cholesterol levels, in particular, very high levels of LDL or the bad cholesterol and premature heart disease. Patients with FH are at an increased risk of developing premature heart disease at an earlier age of 30 to 40 years. Heterozygous FH is a common genetic disorder, occurring in 1:500 people in most countries. Homozygous FH is much rarer, occurring in 1 in a million births. Heterozygous FH is normally treated with drugs. Homozygous FH often does not respond to medical therapy and may require apheresis or liver transplant. Heterozygous FH is when the FH gene is inherited only from one parent. If both parents have FH and the FH gene is inherited from both of them, this is homozygous FH. Universal screening at the age of 16 years should be done to detect familial high cholesterol levels. In patients with heterozygous FH, the cholesterol levels are between 350 to 500 mg/dL, and in homozygous, the levels are between 700 to 1,200 mg/dL.